title: Trends in cost sharing among selected high income countries--2000-2010.
abstract: Many high income countries increased their level of patient cost sharing between 2000 and 2010 as one component of their policy agenda to reduce the level of health care spending. We use data from the OECD, European Observatory, and country-specific resources to analyze trends in the UK, Germany, Japan, France, and the United States. Some forms of cost sharing-deductibles, co-insurance, or co-payments-increased in all these countries, with the highest rates of increase occurring in the pharmaceutical sector. In spite of higher levels of cost-sharing, out-of-pocket spending as a percentage of total spending remained unchanged in most of these countries because they instituted programs to protect certain categories of individuals by creating out-of-pocket limits, exempting people with certain chronic diseases, or eliminating cost sharing for certain demographic groups and low-income people.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway Avenue, Hampton House, Suite #310, Baltimore, MD, United States. Electronic address: hzare@jhsph.edu.
authors.forename: Zare
authors.initials: Z
authors.lastname: Hossein
authors.forename: Anderson
authors.initials: A
authors.lastname: Gerard
mesh_terms: D017047:Cost Sharing / Q000639:trends*; D016208:Databases, Factual; D003695:Delivery of Health Care / Q000191:economics; D019049:Developed Countries; D005382:Financing, Personal / Q000191:economics; D005102:Health Expenditures / Q000639:trends; D006801:Humans
keywords: Co-insurance; Co-payment; Cost sharing; Deductibles; Out-of-pocket; Vulnerable groups